Acupuncture Treatment for Constipation （便秘）

The Introduction of Constipation

Definition

Constipation means difficulty in eliminating stools — usually hard and dry stools. It is called Bian Mi (“blocked stools”) in TCM.

Clinical features

• Constipation with hard and dry stools.
• Gas and bloating.
• Abdominal cramps and pain.
• Bad breath or halitosis.
• Tiredness.

Correspondence to Western diseases
Constipation is a common symptom seen in many diseases, like IBS, hemorrhoids, diverticulitis, and intestinal tumor. It is also seen in elderly and bedridden patients.

The Etiology of Constipation

An irregular diet such as drinking alcohol or eating spicy foods → creates Fire → accumulation of Heat in the Intestines → burning of fluids → dry stools.

A Yang Excess Constitution or Warm Disease consumes Yin fluids, leading to Dry-Heat in the Intestine.

Anger or worry → damages the Liver → Qi stagnation; lack of exercise → Qi stagnation too. Liver Qi stagnation can overact on SP/ST to produce constipation.

Overwork consumes Qi; seniors, and people recovering from long-term illness, surgery, or labor have weak Qi and Blood. Qi deficiency fails to move the Intestines, and Blood deficiency fails to nourish the Intestines, which creates constipation.

A Yang deficiency constitution creates Cold, which congeals fluids and leads to constipation.

Overall, the most common causes of constipation in the clinic are Heat and Qi and Blood deficiency.

The Chief Pathology is the Large Intestine failing to pass the stools. The Large Intestine is the major organ involved, but it is associated with the Spleen, Stomach, Liver, and Kidney. There are four types of constipation: Cold, Heat, Deficiency, and Excess.

How to Diagnose and differentiate Constipation (see Table 8)

Tongue diagnosis

• A red tongue with little or no coating, dry — Blood and Body Fluid deficiency.
• A pale tongue with little coating — Qi and Blood deficiency.
• A white slippery coating — accumulation of Cold in the interior.
• A thick Yellow, and greasy coating — Heat in the Yangming organs (LI, ST).

Stool diagnosis

• Dry and hard stools, and a burning sensation around the anus during defecation — internal Dry-Heat.
• Constipation with not very dry stools, difficulty in emptying the bowels, and a bearing-down sensation around the anus — Qi deficiency.

Abdominal palpation

• Constipation + abdominal distension with dislike of touch or pressure — excess.
• Constipation + abdominal distension with preference for touch — deficiency.

The Treatment of Constipation

Principle of treatment

• Biao
  • Promote bowel movement.

Basic points: BL 25, ST 25, TE 6, KI 6.

• Ben
  • For Heat — clear Heat and lubricate the Intestines.
  • For Qi stagnation — regulate Qi and move stagnation.
  • For deficiency — tonify Qi and Blood and warm Yang to dispel Cold.

Herbal

See chart.

Acupuncture

(1)Main points

• ST 25, BL 25, TE 6, KI 6.

For hypochondriac pain → LR 14, GB 24.

For severe abdominal distension → SP 15.

Excessive sweating → HT 6.

Palpitations → PC 6.

Prolapse of the anus → GV 20, 1.

Low back pain → BL 40.

(2)For Qi deficiency

• Use ST and SP points as primary points.
• Use the Conception Vessel and Back Shu points as secondary points.
• Tonifying and moxa.

(3)For blood deficiency

• “Four Flowers” technique: BL 17 and BL 18 (both sides) is a good Blood tonic, and also moves Blood.

(4)For Yang deficiency

• Use KI and CV Meridians as primary ones.
• Use Back Shu points as secondary ones.
• Tonify with moxa.

Moxa

• CV 6

Auricular

• Rectum
• Large Intestine
• San Jiao
• Lung
• Spleen
• Stomach

(Needles or ear seeds).

Electrostimulation

• SP 15 connected with ST 37.
• CV 5 connected with TE 6.
• Mixed wave, 10–20 min, every other day, alternating the groups.

Suggestions

• Drink more water (to the point of quenched thirst and pale urine).
• Get more exercise.
• Include more fiber in the diet.
• Eat regular meals.
• Do not consume too much spicy, greasy food or alcohol.
• Establish a regular bowel habit.
• Calm the mind and reduce stress.
• Perform abdominal massage.
• Prevent or treat hemorrhoids.